Aydemir Koçarslan

Thymoquinone protects end organs from abdominal aorta ischemia/reperfusion injury in a rat model

Introduction Previous studies have demonstrated that thymoquinone has protective effects against ischemia reperfusion injury to various organs like lungs, kidneys and liver in different experimental models. Objective We aimed to determine whether thymoquinone has favorable effects on lung, renal, heart tissues and oxidative stress in abdominal aorta ischemia-reperfusion injury. Methods Thirty rats were divided into three groups as sham (n=10), control (n=10) and thymoquinone (TQ) treatment group (n=10). Control and TQ-treatment groups underwent abdominal aorta ischemia for 45 minutes followed by a 120-min period of reperfusion. In the TQ-treatment group, thymoquinone was given 5 minutes. before reperfusion at a dose of 20 mg/kg via an intraperitoneal route. Total antioxidant capacity, total oxidative status (TOS), and oxidative stress index (OSI) in blood serum were measured and lung, kidney, and heart tissue histopathology were evaluated with light microscopy. Results Total oxidative status and oxidative stress index activity in blood samples were statistically higher in the control group compared to the sham and TQ-treatment groups (P<0.001 for TOS and OSI). Control group injury scores were statistically higher compared to sham and TQ-treatment groups (P<0.001 for all comparisons). Conclusion Thymoquinone administered intraperitoneally was effective in reducing oxidative stress and histopathologic injury in an acute abdominal aorta ischemia-reperfusion rat model.

High aortic pulse-wave velocity may be responsible for elevated red blood cell distribution width in overweight and obese people: a community-based, cross-sectional study.

Summary Background: Obesity and overweight are risk factors for atherosclerosis. Red blood cell distribution width (RDW) is associated with subclinical cardiac diseases. The aim of this study was to investigate the association between RDW and aortic stiffness in overweight or obese subjects. Methods: A total of 101 overweight or obese subjects without overt cardiovascular disorders, and 48 healthy controls were enrolled. RDW, aortic pulse-wave velocity (PWV) and augmentation index 75 (Aix75) were evaluated. The case subjects were divided into two sub-groups according to PWV values; ≥ 10 m/s in group I, and < 10 m/s in group II. Bivariate correlation and multiple regression analyses (stepwise) were performed. Results RDW and PWV were considerably increased in the case groups compared with the controls. RDW was significantly increased in group I compared with group II and the controls [median 12.0 m/s, interquartile range (IQR): 10.5–17.5; median 11.7 m/s, IQR: 10.2–14.2, and median 11.4 m/s, IQR: 9.6–15.5, p < 0.05, respectively]. Resting heart rate and age were higher in group I than group II (81 ± 11 vs 74 ± 12 beats/min and 41 ± 120 vs 36 ± 9 years, respectively, p < 0.05). Regression analyses revealed that while log-RDW, age and resting heart rate were independent predictors for aortic PWV, log-RDW was the most important predictor in the final model. Conclusions: RDW, resting heart rate and age independently predicted arterial stiffness, and RDW may be useful to provide an early recognition of subclinical atherosclerosis in overweight and obese individuals.

Asymptomatic cervical mature teratoma in a child: an unusual presentation.

Sir, Teratomas originate from multipotent primitive germ cells, leading to different tissues that are foreign to the anatomical site of origin. They are embryonic tumours and appear in about 1:20,000-40,000 live births. Teratomas may develop in any part of the body; however, the sacrococcygeal region is the most common location [1]. Only 1.5% to 5.5% of all paediatric teratomas occur at the cervical region. Although cervical teratomas are generally benign, they can be fatal due to respiratory distress, if not excised [2]. We aimed to present the case of a 2-year-old female with a cervical teratoma without airway obstruction. A 2-year-old female was admitted to our hospital with a slowly enlarging cervical tumour first noticed during the neonatal period. There were no symptoms of distress in this patient during the fetal period. Surgical treatment was planned at the second month; however, the patient was not operated on due to an acute pulmonary infection. At that point the patient was treated for the pulmonary infection and discharged from the hospital. Clinical follow-up was not done and, thus far, there were no symptoms with regard to the cervical mass. Currently, upon physical examination, the tumour was determined to be 5x4 cm in diameter, and palpated in the left anterior region of the neck. The mass was immobile and had an elastic consistency. There was no indication of respiratory distress. The results of the hematological tests and thyroid function tests were within normal limits. The preoperative appraisal of the patient consisted of X-rays, ultrasonography and magnetic resonance imaging to evaluate the extent of the tumour. Cervical x-rays revealed minimal tracheal deviation, and calcification was not observed in the tumour. US showed a multiloculated cystic mass with internal septations. The MRI showed the presence of a 31x53x46 mm mass with cystic components, located in the left lobe of the thyroid, and extending from the submandibular region to the mediastinal entry. The cystic fluids were shown to be of low intensity on the Tl-weighted MRI, and of high intensity on the T2-weighted MRI [Table/Fig-1]. Complete surgical excision of the tumour was carried out, and upon macroscopic examination, the tumour was 5x3x2.5cm in diameter and composed of many cystic lumina containing gelatinous fluid and solid areas. Upon histopathological examination, all of the components of the tumour were mature, and glial tissue, cartilage, striated muscle, enteric type mucosa and bronchial epithelium were observed [Table/Fig-2]. The tumour was diagnosed as a mature teratoma. [Table/Fig-1]: (a,c) MRI of the cervical region demonstrating a mass with cystic and solid compartments, which is high intensity on the T2-weighted MRI, and (b) low intensity on the Tl-weighted MRI [Table/Fig-2]: (A)Microscopic photograph of the tumour showing glial tissue, respiratory (B) and enteric type mucosa (H&E x100 and x200,respectively) Cervical teratomas are primitive germ cell neoplasms with a poor clinical outcome. The pathogenesis is not well established; however, it has been reported that cervical teratomas arise from the embryonic thyroid anlage. Teratomas occurring in the cervical region are rare entities, which were first described by Hess in 1854 [3]. A study of teratomas by Gonzalez-Crussi reported that only 3.4% of the cases were in the cervical region [4]. They are usually solitary; although, multifocality has also been reported [1]. In our case, the tumour presented as a solitary mass and multifocality was not detected. Teratomas may enlarge and compromise the airway, and although histopathologically benign, they may be fatal at the time of birth due to airway obstruction. These require immediate surgical treatment. Large tumours may cause cervical hyperextension, esophageal obstruction and polyhydramnios. Polyhydramnios is reported in about 19% of the cases. The degree of airway obstruction and polyhydramnios relate to the size of the tumour [1]. In our case, compression related findings, such as respiratory distress, esophageal obstruction and polyhydramnios, were not present, probably due to the small size of the tumour. They may contain cartilage, bone, fatty tissue, skin, hair, glial tissue and components of the respiratory or digestive tract [1,5]. In our case, all of the components of the tumour were mature, and glial tissue, bone, cartilage, striated muscle and bronchial epithelium were observed. In conclusion, congenital cervical teratomas are extremely rare neoplasm. Although they are usually benign in origin, these tumours are associated with a high mortality rate due to respiratory distress and require immediate surgical excision. Our case is rare in the literature due to the fact that it is clinically asymptomatic.

Bilateral Extracranial Internal Carotid Artery Aneurysm: Original Image

A 63-year-old woman was admitted to our clinic with the complaint of dizziness. Doppler ultrasound and computerized tomography angiography scan demonstrated bilateral fusiform internal carotid artery aneurysms (Figure 1). Left internal carotid artery’s diameter was 21 mm and right internal carotid artery’s diameter was 11 mm. The patient refused endovascular stent grafting, therefore medical treatment was given including antiaggregants and antihypertensives.

A very rare coronary artery anomaly, intercoronary communication, that may be lucky for some patients

We read the paper by Abreu et al. entitled ‘Coronary arcade: A rare anomaly of the coronary circulation’ with great interest, and we thank them for their interesting report. They asserted that the cause of the chest pain and ECG alterations observed during exercise testing in the case presented may be the result of transient disturbances in coronary blood flow during the test. Furthermore, they state that intercoronary communication (ICC) may be unrelated to ischemia, and that it may even function as a natural bypass, protecting against ischemia. Herein, we present our case supporting their idea.

Koroner bypass ameliyatı öncesi trimetazidin kullanımının oksidatif parametreler üzerine etkileri

Amac: Koroner arter bypass greft cerrahi (KABG)\sinde olusan miyokardiyal iskemi- reperfuzyon hasari uzerinde trimetazidin (TMZ) kullaniminin koruyucu etkisinin prospektif olarak arastirilmasi amaclandi. Yontemler: 2008-2009 yillari arasinda klinigimizde elektif sartlarda KABG ameliyatina alinan 35 hasta calismaya dahil edildi. Olgular randomize olarak iki gruba ayrildi. Olgularin 17\sine ameliyattan iki hafta oncesinden TMZ verildi, kontrol grubundaki 18 hastaya verilmedi. Hastalardan ameliyat oncesi, ameliyat esnasi ve ameliyat sonrasinda venoz ve kardiyopulmoner bypass baslarken ve sonrasi donemde koroner sinus kan ornekleri alindi. Calisma sonunda total oksidatif durum (TOS) ve total antioksidan kapasite (TAS) calisildi ve oksidatif stres indeksi (OSI) hesaplandi. Oksidatif parametreler uzerinde ameliyat stresi ve trimetazidin kullaniminin etkisi tekrarlayan olcumler varyans analizi ile incelendi. Bulgular: Trimetazidin kullaniminin total antioksidan kapasite, total oksidatif stres ve oksidatif stres indeksi uzerinde istatistiksel anlamli etkisi olmadigi tespit edildi (p>0,05). Buna karsin tekrarlayan olcumlerde oksidatif stres parametrelerinde ameliyat stresinin etkilerini yansitacak sekilde istatistiksel anlamli degisiklikler saptandi (p